夫西地酸乳膏对比莫匹罗星软膏治疗革兰阳性菌感染性皮肤病的临床循证研究  

Efficacy and Safety of Sodium Fusidate Ointment Versus Mupirocin Ointment in Treatment of Bacterial Skin Infection

作　　者：石娴[1] 付曼妮 解翠林[1] 邹爱玲[1] 

机构地区：[1]鄂东医疗集团黄石市中心医院皮肤性病科,湖北黄石435000

出　　处：《解放军药学学报》2017年第3期272-275,共4页Pharmaceutical Journal of Chinese People's Liberation Army

摘　　要：目的系统评价夫西地酸乳膏对比莫匹罗星软膏治疗细菌感染性皮肤病的有效性及安全性。方法计算机检索PubMed、Medline、CNKI、VIP、万方等数据库建库至2016年7月的文献,手动检索相关杂志、会议论文及学术论文,收集夫西地酸乳膏与莫匹罗星软膏治疗细菌感染性皮肤病的随机对照研究,由2名研究者独立提取数据、评价质量,并交叉核对。采用RevMan 5.2软件进行Meta分析。结果纳入14项研究,1959例患者,夫西地酸乳膏组980例,莫匹罗星软膏组979例。Meta分析结果显示,夫西地酸乳膏的临床总有效率[RR=1.08,95%CI(1.05,1.12),P<0.000 01],EASI评分改善程度[MD=-2.06,95%CI(-2.43,-1.69),P<0.000 01]和瘙痒症状评分改善程度[MD=-0.65,95%CI(-0.72,-0.58),P<0.000 01]显著优于莫匹罗星软膏,且ADR发生率[RR=0.33,95%CI(0.17,0.66),P=0.002]较小,但是细菌清除率比较无显著性差异[RR=1.03,95%CI(0.94,1.14),P=0.48]。倒漏斗图提示纳入研究发表偏倚性较小。结论现有证据表明,夫西地酸乳膏治疗细菌感染性皮肤病的有效性和安全性均优于莫匹罗星软膏,值得临床推广。Objective To systematically review the efficacy and safety of sodium fusidate ointment versus mupirocin ointment in the treatment of bacterial skin infections. Methods Databases including PubMed,Medline,CNKI,VIP and Wanfang were searched to collect data on randomized controlled trials （RCTs） related to sodium fusidate ointment versus mupirocin ointment in the treatment of bacterial skin infections from inception to May 2016. At the same time, relevant research references were manually retrieved.Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies.Then,meta-analysis was conducted with RevMan 5.2 software.Results A total of 14 RCTs and 1959 patients were included. Meta-analysis showed that sodium fusidate ointment was significantly better than mupiroein ointment in total effective rate [RR= 1.08,95GC1（1.05,1.12）, P %0.000 01], improvement in EASI score [MD=--2.06,95%CI（-2.43,-1.69）, P 〈0.000 01] and improvement in pruritus symptom scores [MD=-0.65,95GCI（-0.72,-0.58）, P 〈0.000 01].Meanwhile,the rate of ADRs was much lower [RR=0.33,95]CI（0.17,0.66）, P =0.0021 ,but there was no significant difference in the rate of bacterial clearance [RR=1.03,95]CI（0.94,1.14）, P =0.48].The inverted funnel plot suggested that the inclusion bias was small.Conclusion Current evidence shows that sodium fusidate oint- ment is more effective and safer in treatment of bacteria skin infections than mupirocin ointment .

关 键 词：夫西地酸乳膏 莫匹罗星软膏 皮肤细菌感染 循证研究 

分 类 号：R969.3[医药卫生—药理学]